Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 12786 | Date 02/12/2023 |
| Token No | SM/22-23/26693 02/12/2023 | Serial | 024 Last Visit: 21/10/2025 |
| Patient Name | Mrs. JAYANTI BANERJEE | Contact No | |
| Address | GOPALPUR AKUNI | Age | 45 Years,9 Months,19 Days Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||